Clinical importance and cost of bacteremia caused by nosocomial multi drug resistant acinetobacter baumannii

• We investigated risk factors for MDR A. baumannii bacteremia.
• We investigated risk factors associated with mortality of MDR A. baumannii bacteremia.
• Our study showed that occurance of MDR A. baumannii bacteremia was related to the usage of wide spectrum antibiotics and there was no difference between cost of MDR A. baumannii bacteremia and cost of bacteremia due to the other Gram-negative microorganisms.
• Infection control precautions and limited antibiotic usage are very important for prevent MDR nosocomial infections.

SummaryBackgroundA. baumannii is an important nosocomial pathogen associated with high mortality, morbidity and medical cost.AimThe aim of this study was to investigate risk factors for MDR A. baumannii bacteremia and also evaluate cost of hospitalization of these patients.MethodsStudy was conducted in Ankara Atatürk Training and Research Hospital. Patients who were hospitalized in ICU and diagnosed for nosocomial blood stream infection (BSI) between January 2007 and December 2010 were checked retrospectively. Patients with nosocomial BSI caused by multidrug resistant A. baumannii were compared with the patients who had BSI caused by other Gram-negative microorganisms in terms of risk factors, mortality and medical costs.FindingsIn multivariate analysis previous use of carbapenem, quinolone and metronidazole, and SAPS II score were found as independent risk factors. In case group; immunosupression, SAPS II score, and hospital stay until infection were independently associated with mortality in multivariate analysis.ConclusionOur results suggest that the occurrence of MDR A.baumannii bacteremia was related with the usage of the wide spectrum antibiotics, and mortality rates were increased in patients that high SAPS II scores, long term hospitalization. Infection control procedures and limited antibiotic usage are very important for prevent nosocomial infections.